There are a number of risks associated with epidural anesthesia, a form of regional anesthesia where drugs are administered into the epidural space to decrease pain sensations in the lower body. Most epidural risks are relatively uncommon. In some cases, patients may experience a sudden drop in blood pressure, or, even more rarely, infections, nerve damage around the site of the epidural, allergic reactions, seizures, and cardiac arrest. As this anesthesia option is most commonly utilized during childbirth, there also are risks to the baby, including lethargy. Epidural risks are greatly reduced by working with an experienced care team and in some facilities, the incidence of risks is very low when compared to the general population.
If a patient receiving an epidural experiences a sudden drop in blood pressure, it can lead to further complications. Most facilities hydrate patients with fluids before giving an epidural and during the course of the anesthesia to mitigate this risk. A relatively rare complication is a dural puncture leading to a post dural puncture headache. During an epidural, the patient will have decreased sensation in the lower body and may have difficulty urinating or defecating. Soreness around the epidural site can also be a problem.
For cases where epidurals used in childbirth cause lethargy in the baby, breastfeeding attempts immediately after delivery may be difficult, and other complications of this condition can include increased medical interventions, and slowed or stopped labor. It is also important for the mother to change positions regularly during delivery, as the baby's heart rate may slow if the mother does not move around during an epidural.
Sometimes, people experience no decrease in sensation after an epidural is administered. This is a rare risk, but can happen, and people should not be afraid to speak up if they are experiencing sensations when they should not be.
Screening before epidural anesthesia is designed to eliminate people obviously at risk for complications from an epidural, such as individuals with a history of bad reactions to drugs used in epidural anesthesia, individuals with clotting disorders, and people with existing infections in their backs. It is important to be honest and accurate during anesthesia screening to help an anesthesiologist make safe choices for the patient.
While some of the more serious epidural risks can sound frightening, their incidence is low, and even lower when the anesthesia is administered by a skilled and experienced anesthesiologist, nurse anesthetist, or anesthesia technician. If a care provider has difficulty or feels uncertain about an epidural, another member of the medical team will be called in to assist and discuss, and if the procedure is not deemed appropriate due to concerns about epidural risks, other options will be explored.
